Goldberg Robert J, Katz Joel
Department of Psychology, York University, Toronto, ON, Canada.
Pain. 2007 May;129(1-2):210-23. doi: 10.1016/j.pain.2007.01.020. Epub 2007 Mar 1.
Between 40% and 60% of Americans use complementary and alternative medicine to manage medical conditions, prevent disease, and promote health and well-being. Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) have been used to treat joint pain associated with several inflammatory conditions. We conducted a meta-analysis of 17 randomized, controlled trials assessing the pain relieving effects of omega-3 PUFAs in patients with rheumatoid arthritis or joint pain secondary to inflammatory bowel disease and dysmenorrhea. Meta-analysis was conducted with Cochrane Review Manager 4.2.8. for six separate outcomes using standardized mean differences (SMDs) as a measure of effect size: (1) patient assessed pain, (2) physician assessed pain, (3) duration of morning stiffness, (4) number of painful and/or tender joints, (5) Ritchie articular index, and (6) nonselective nonsteroidal anti-inflammatory drug consumption. Supplementation with omega-3 PUFAs for 3-4 months reduces patient reported joint pain intensity (SMD: -0.26; 95% CI: -0.49 to -0.03, p=0.03), minutes of morning stiffness (SMD: -0.43; 95% CI: -0.72 to -0.15, p=0.003), number of painful and/or tender joints (SMD: -0.29; 95% CI: -0.48 to -0.10, p=0.003), and NSAID consumption (SMD: -0.40; 95% CI: -0.72 to -0.08, p=0.01). Significant effects were not detected for physician assessed pain (SMD: -0.14; 95% CI: -0.49 to 0.22, p=0.45) or Ritchie articular index (SMD: 0.15; 95% CI: -0.19 to 0.49, p=0.40) at 3-4 months. The results suggest that omega-3 PUFAs are an attractive adjunctive treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.
40%至60%的美国人使用补充和替代医学来管理医疗状况、预防疾病以及促进健康和幸福。ω-3多不饱和脂肪酸（ω-3 PUFAs）已被用于治疗与多种炎症性疾病相关的关节疼痛。我们对17项随机对照试验进行了荟萃分析，评估ω-3 PUFAs对类风湿性关节炎患者或炎症性肠病及痛经继发关节疼痛的止痛效果。使用Cochrane系统评价软件4.2.8对六个独立结局进行荟萃分析，采用标准化均数差（SMD）作为效应量的衡量指标：（1）患者自评疼痛，（2）医生评估疼痛，（3）晨僵持续时间，（4）疼痛和/或压痛关节数，（5）里奇关节指数，以及（6）非选择性非甾体抗炎药的消耗量。补充ω-3 PUFAs 3至4个月可降低患者报告的关节疼痛强度（SMD：-0.26；95%置信区间：-0.49至-0.03，p = 0.03）、晨僵时间（SMD：-0.43；95%置信区间：-0.72至-0.15，p = 0.003）、疼痛和/或压痛关节数（SMD：-0.29；95%置信区间：-0.48至-0.10，p = 0.003）以及非甾体抗炎药的消耗量（SMD：-0.40；95%置信区间：-0.72至-0.08，p = 0.01）。在3至4个月时，未检测到医生评估疼痛（SMD：-0.14；95%置信区间：-0.49至0.22，p = 0.45）或里奇关节指数（SMD：0.15；95%置信区间：-0.19至0.49，p = 0.40）有显著效果。结果表明，ω-3 PUFAs是类风湿性关节炎、炎症性肠病和痛经相关关节疼痛的一种有吸引力的辅助治疗方法。
